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Schizophrenia is a serious mental illness that interferes with a person's ability to think clearly, manage emotions, make decisions, and relate to others. It is a complex, long term medical illness. People with this disorder experience distortions of reality, often experiencing delusions or hallucinations.
The exact prevalence of schizophrenia is hard to measure, but estimates range from 0.25% to 0.64% of U.S. adults. Although schizophrenia can occur at any age, the average age onset tends to be in the late teens to early 20s for men, and the late 20s to early 30s for women. It is uncommon for schizophrenia to be diagnosed in a person younger than 12 or older than 40.
Misconceptions about this disorder are common. For example, some people think that it creates a "split personality." In fact, schizophrenia and "split personality" (dissociative identity disorder) are two different disorders.
It can be difficult to diagnose schizophrenia in teens. This is because the first signs can include a change of friends, a drop in grades, sleep problems, and irritability. These are all common and nonspecific adolescent behavior. Other factors include isolating oneself and withdrawing from others, an increase in unusual thoughts and suspicions, and a family history of psychosis. In young people who develop schizophrenia, this stage of the disorder is called the "prodromal" period.
With any condition it's essential to get a comprehensive medical evaluation in order to obtain the best diagnosis. For a diagnosis of schizophrenia, some of the following symptoms are present in the context of reduced functioning for at least six months:
Hallucinations are experiences that appear real but are created by the mind. They include seeing things, hearing voices, or smelling things others around you don't experience. The hallucination is very real to the person experiencing it, and may be very confusing for a loved one to witness. The voices in the hallucinations can be critical or threatening.
These are false beliefs that don't change even when the person who holds them is presented with new ideas or facts. People who have delusions also often have problems concentrating, confused thinking, or the sense that their thoughts are blocked.
These are unusual ways of thinking or processing information.
These include agitated body movements or strange postures.
Negative symptoms of schizophrenia interrupt a person's typical emotions, behavior, and abilities. These symptoms include:
Cognitive symptoms of schizophrenia are sometimes subtle and may be difficult to detect. The disorder can affect memory and thinking. Symptoms include:
Research suggests that schizophrenia may have several possible causes:
Schizophrenia isn't caused by just one genetic variation, but a complex interplay of genetics and environmental influences. Heredity does play a strong role. A person's likelihood of developing schizophrenia is more than six times higher if they have a close relative, such as a parent or sibling, with the disorder.
Exposure to viruses or malnutrition before birth, particularly in the first and second trimester, has been shown to increase the risk of schizophrenia. Recent research also suggests a relationship between autoimmune disorders and the development of psychosis.
Problems with certain brain chemicals, including neurotransmitters called dopamine and glutamate, may contribute to schizophrenia. Neurotransmitters allow brain cells to communicate with each other. Networks of neurons are likely involved as well.
Some studies suggest that taking mind-altering drugs during teen years and young adulthood can increase the risk of schizophrenia. A growing body of evidence indicates that smoking marijuana increases the risk of psychotic incidents and the risk of ongoing psychotic experiences. The younger and more frequent the use, the greater the risk.
Diagnosing schizophrenia is not easy. Sometimes using drugs, such as methamphetamines or LSD, can cause a person to have schizophrenia-like symptoms. The difficulty of diagnosing the illness is compounded by the fact that many people who are diagnosed don't believe they have it. Lack of awareness is a common symptom of people diagnosed with schizophrenia and greatly complicates treatment.
While there is no single psychical or lab test that can diagnose schizophrenia, a health care provider who evaluates the symptoms and the course of a person's illness over six months can help ensure a correct diagnosis. The health care provider must rule out other factors such as brain tumors, possible medical conditions, and other psychiatric disorders.
To be diagnosed with schizophrenia, a person must have two or more of the following symptoms occurring persistently in the context of reduced functioning:
Delusions or hallucinations alone can often be enough to lead to a diagnosis of schizophrenia. Identifying it as early as possible greatly improves the person's chances of managing the illness, reducing psychotic episodes, and recovering. People who receive good care during their first psychotic episode are admitted to the hospital less often, and may require less time to control symptoms than those who don't receive immediate help.
People can describe symptoms in a variety of ways. How a person describes symptoms often depends on the cultural lens they are looking through. African Americans and Latinos are more likely to be misdiagnosed, potentially due to differing cultural perspectives or structural barriers. Any person who has been diagnosed with schizophrenia should try to work with a health care professional that understands their cultural background and shares the same expectations for treatment.
There is no cure for schizophrenia but it can be treated and managed in several ways:
There's no way to prevent schizophrenia. Still, identifying who's at risk and how to prevent the disorder from occurring in at-risk individuals has been an important focus of researchers in recent years.
It's possible to enjoy a happy, healthy, and symptom-free life. Schizophrenia symptoms can go away for awhile and then return. Following the doctor's recommendations will improve the prognosis.
According to the Royal College of Psychiatrists, 3 out of every 5 people diagnosed with schizophrenia will get better with treatment. To get on the road to improvement, it's important to: learn about the condition, understand the risk factors, and follow the doctor's treatment plan.